GP articles from March 2011

GP archives from March 2011

Opinion: Aptitude tests have me testing my patience.
March 25, 2011... Recently I was critical of the aptitude tests, which are now a pre-requisite for entry to medical school. However, I've matured since; it takes a big man to admit he's wrong, and I'm quite enormous. I realise now that I was being a bit...

Opinion: More often than not, the end justifies the means.
March 25, 2011... Mr Wheezy, suffering the pangs of acute nicotine withdrawal, tried hard to get me to visit. Too hard, in fact. When I said I wouldn't deliver either Champix or Rothmans he went slightly too far and decided he actually had chest pain. ...

Clinical: At a Glance - Prepatellar bursa vs Osgood-Schlatter's disease.
March 25, 2011... Prepatellar bursa (PPB) Aetiology - Bursae are small synovial sacs that often lie over bony prominences, such as the patella. - These may increase in size due to inflammation and an increase of fluid following trauma. - PPB...

Education: CSA troubleshooting - 8 - Telephone consultations.
March 25, 2011... The CSA can include performing consultations over the telephone. Telephone consultations are a regular feature of the CSA. They do not feature in every candidate's exam, but when they do they take place in a separate room on the CSA exam...

Education: Pictorial case study.(Brief article)
March 25, 2011... The case This seven-year-old boy with a history of eczema presented with an itchy scalp. Examination revealed a fine scale, but no erythema or inflammation on the scalp or at the margins. A coal-tar based shampoo was prescribed. After the...

Commissioning: Contracts - Procurement law, red tape and AWPs.
March 25, 2011... GP consortia must understand how awarding contracts will be regulated. Do you know what procurement law means for your commissioning consortium? Or whether the GP leads and managers will have the appropriate skills to deal with it? ...

Clinical: Journals Watch - Leg ulcers, prostate cancer and BMI BMI.
March 25, 2011... Not had time to read the latest research? Let Dr Sally Hope bring you up to date with the journals. Weekly ultrasound for venous leg ulcers - BMJ 2011; 342: d1092 Dressing venous leg ulcers takes enormous resources in primary care Current...

Clinical Review: Hypersensitivity pneumonitis.
March 25, 2011... Section 1: Epidemiology and aetiology Hypersensitivity pneumonitis (HP) is an umbrella term for conditions affecting the lung, characterised by hypersensitivity immune responses to inhaled antigens derived from fungal, bacterial, animal...

Clinical: The Basics - Pharyngitis and laryngitis.
March 25, 2011... In most cases, reassurance and advice on symptom relief will suffice, explains Dr Zara Aziz. Sore throats account for around 10 per cent of all GP consultations Patients may consult repeatedly and self medicate with OTC remedies. Causative...

Clinical: Expert opinion - Spinal cord stimulation.
March 25, 2011... Patients with medically refractory chronic neuropathic pain may benefit from SCS. Chronic pain can be defined as pain lasting longer than the expected duration of the disease. It represents a major health and socio-economic burden, with a UK...

MedEconomics: How to ... Design a repeat scripts protocol.
March 25, 2011... Professor Ruth Chambers explains how you can bring medication reviews into line with best practice. Are you revising the practice's protocol for reviewing patients' repeat medication to bring it up to date? Or perhaps you are starting from...

Plain Tales from the Surgery.
March 25, 2011... - Breast is not best here Some while ago one of our partners made the mistake of referring a female patient with a breast-related problem to the gynaecologist. The letter came back with a note saying: 'Thank you for your referral but...

Education: Online Learning - How e-learning can help treat a sick child.
March 25, 2011... This e-learning resource can give clinical staff the tools to improve their paediatric skills, says Dr Nicholas Blackwell. The internet is a massive resource with fantastic potential, but it can be a double-edged sword, sometimes encouraging...

MedEconomics: Sessional GPs - Why a locum's work is more risky.
March 25, 2011... Locums must heed the higher risk of mistakes compared with other GPs, says Dr Judith Harvey. GPs live with risk. It is what we do everyday when deciding which treatment options are the best for our patients. Being a locum ups the stakes,...

Checking up on suppliers' claims.(Brief article)
March 25, 2011... Step 4 Evaluate potential suppliers instead of taking their promises on trust, urges Nick Coleman. The last three weeks' advice in steps one to three covered the basics of putting together a plan for cutting practice expenses. But all this...

MedEconomics: Ask the Experts - Pay and NHS pensions.
March 25, 2011... Q: SENIORITY PAY I am currently a full-time GP with seniority payments for 35 years' service. I may have to reduce my hours to half time to look after an elderly relative. How will this affect my seniority pay? Reducing your hours to...

MedEconomics: Our low-cost premises upgrades.
March 25, 2011... Deanery funds and money-conscious architects helped us do a lot with only pounds 527,000. Our practice, the Priory Medical Group (PMG), is one of the UK's largest. Based in York, we serve 41,000 patients from six surgeries. We are a...

Commissioning: Consortia and carbon emissions.
March 25, 2011... Andrew Cooper explains NHS policy to embed 'sustainability' in clinical and commissioning decisions. There is a lot of talk about government policy on sustainability. But how it applies to GP commissioning consortia in this era of change is...

BMA vote demands withdrawal of Health Bill.(British Medical Association)
March 25, 2011... Doctors reject all-out opposition to NHS reforms. Doctors at the BMA special representative meeting (SRM) in London last week called for the withdrawal of the Health Bill, but stopped short of all-out opposition to NHS reforms. Around 400...

Meldrum calls for realistic approach to NHS reforms.
March 25, 2011... Dr Meldrum: 'I do not support this Health Bill'. Preventing the Health Bill from being passed is likely to be an 'unachievable feat', the BMA chairman told the special representative meeting last week. Dr Hamish Meldrum warned that it is...

GP ONLINE.COM: A round-up of the best from GP's website this week.
March 25, 2011... NHS Health Bill resources All the news, analysis and key resources for the Health Bill available online. gponline.com /healthbill BMA special meeting BMA members debated the coalition government's NHS reform plans on 15 March at an...

Welsh GPs to discuss NHS cost-saving plans.
March 25, 2011... Conference will discuss GP funding and plans to save money by working together. GPs in Wales will discuss working in 'localities' to help save resources and shape local services later this month. The annual conference of Welsh LMCs, in...

Rationing of health services across Europe is inevitable.
March 25, 2011... The cost of healthcare across Europe is rising faster than governments' ability to fund it, according to a report by the Economist Intelligence Unit. The report identified seven key trends that will shape healthcare over the next two decades....

GPs face longer suspensions.
March 25, 2011... GP suspensions from work last twice as long as those for hospital and community doctors, National Clinical Assessment Service (NCAS) figures show. The statistics reveal that for the small numbers of GPs affected, suspensions or exclusions...

GPs must back self care in tough times.
March 25, 2011... Patients taking more responsibility could play greater role in primary care. GPs must become advocates of self care in the shadow of 'stark' choices facing the NHS, the chairman of the NHS Alliance has said. Dr Michael Dixon said the Self...

Labour launches petition to protect future of the NHS.(Brief article)
March 25, 2011... Labour launched a petition to 'save the NHS' last week as BMA members discussed the Health Bill at an emergency meeting in London. The petition calls on the government and prime minister David Cameron to: - Protect frontline NHS services....

Social care cost to hit NHS hard.(national health services)(Brief article)
March 25, 2011... The NHS could crumble under the pressure created by a pounds 1 billion funding gap in social care, unions have warned. Unison say local authorities face budget cuts of up to 27 per cent and cannot protect their adult care spending. The...

GPs win four-figure seniority payout.
March 25, 2011... GP leaders and accountants have urged GPs to check they received correct pay. Hundreds of GPs may be able to claim back thousands of pounds in seniority pay for the 2007/8 financial year, according to accountants. GP leaders say repayments...

GP fundraiser rewarded.
March 25, 2011... A Berkshire GP has won a special 'top fundraiser' award from the British Heart Foundation (BHF) after taking part in events to support the charity. Dr Jenny Langdon, from Maidenhead, was handed the award at a BHF prize giving event last month...

What will the SRM votes achieve?(special representative meeting )
March 25, 2011... A close vote saw doctors decide against all-out opposition to the Health Bill. Susie Sell and Tom Ireland report. As 400 doctors came together in London to thrash out their approach to the NHS reforms, the profession at first stood united...

Opinion: Ballot Box.
March 25, 2011... 54% of GPs do not think the UK contract should be split so each country has a separate one. Source: GP. -------------------- Did you find this article useful? Why not subscribe to the magazine? Please call 08451 55 73 55 for more...

Opinion: Your say online ... gponline.com/news.
March 25, 2011... GP leaders welcome Lib Dem opposition to Health Bill Don't believe that a few little amendments will do anything to stop the march of privatisation that is inherent in this ill-thought-out Bill This government is intent on farming everything...

Editorial: Commissioning 'key' but so is practice support.(Editorial)
March 25, 2011... So what did we learn at last week's BMA special representative meeting (SRM)? It may have backed scrapping the Health Bill but it did not oppose commissioning, which is arguably its big idea. The BMA's policy of 'critical engagement' with the...

Opinion: Early retirees remain lions led by donkeys.
March 25, 2011... We are all going to have to work longer before we can retire. A generous pension which could be drawn early was always a major perk of working in the NHS and helped counter some of its more difficult aspects. But the banking crisis and the...

GPs must join up to end care lottery.
March 25, 2011... Two-year King's Fund inquiry backs GPs but calls for significant reform. GP practices should be opened up to peer and public scrutiny to cut variations in standards of care, according to a two-year investigation of general practice by the...

Exclusive - PCT bid to cut costs endangers patients.
March 25, 2011... GPC warning over PCTs leaning on practices to drive down diagnostic referrals. PCTs could be putting patients at risk by pressuring practices to cut their use of diagnostic tests, GP leaders have warned. GPC negotiator Dr Chaand Nagpaul...

CMO raises flu jab target for GPs.
March 25, 2011... England's CMO has called for a steep rise in uptake of the flu jab among pregnant women. In a letter to SHA and PCT immunisation and flu co-ordinators, Professor Dame Sally Davies said GPs should aim to hit 60 per cent uptake among pregnant...

BMA to step up its Health Bill opposition.(British Medical Association)(Brief article)
March 25, 2011... The BMA is to 'step up' its opposition to the Health Bill and demand major changes to the government's NHS reforms. The GPC has also issued 'more forceful' guidance to the profession following the BMA special representative meeting last week,...

GMC hearings to be independent.
March 25, 2011... Confidence in decisions at fitness to practise hearings could be strengthened by the creation of a new independent tribunal service under GMC plans. The regulator has launched a consultation, which runs until 13 June, to outline its plans to...

QOF will not pay GPs for rationing NHS care.
March 25, 2011... Northern Ireland contract delay hits release date for new QOF efficiency indicators for 2011/12. GPC negotiators insist new indicators added to the 2011/12 QOF to drive efficiency will not amount to paying practices to cut referrals. ...

Tory GP MP warns reforms will privatise commissioning.
March 25, 2011... Tory MP and GP Dr Sarah Wollaston (Con, Totnes) has launched a scathing attack on her party leader David Cameron and health secretary Andrew Lansley's NHS reforms. The MP, who has previously likened the reforms to throwing 'a grenade' into...

Consortia must save pounds 4bn by 2014.
March 25, 2011... DoH QIPP lead says estates and hospital cuts will help GPs hit savings target. Just 20 per cent of the pounds 20 billion NHS efficiency savings target will come from service redesign by GP consortia, a senior DoH official has said. Jim...

DoH drugs plan could raise NHS costs.
March 25, 2011... DoH plans for 'value-based pricing' of drugs could increase costs without improving treatment effectiveness, the NHS Confederation has warned. Responding to a recent consultation on the plans, the body said drugs given a value-based price may...

Prenatal nicotine cause of smoking.
March 25, 2011... Exposure to nicotine in the womb may increase the risk of smoking in later life, research suggests. Researchers from the University of Helsinki, Finland, found prenatal exposure to nicotine among mice increased vulnerability to nicotine...

Consortia told to ignore DoH advice.
March 25, 2011... GPs should ignore the DoH's first draft of consortia functions, according to the GPC. The DoH document does not have the committee's approval and contains a number of 'worrying duties' for GP commissioners, said GPC negotiators. GPC...

GP consortia face fines of up to 10% of turnover.
March 25, 2011... Competition Labour warns of the financial penalties in plans to hand Monitor similar powers to the OFT. GP consortia could be fined up to 10 per cent of turnover for anti-competitive practice by the regulator Monitor under NHS reforms, Labour...

GP Diary.
March 25, 2011... FOR THEIR EYES ONLY An embarrassing blunder at BMA House meant GPC briefing papers marked 'CONFIDENTIAL' were placed in a room full of journalists waiting for a press briefing. The documents were snapped up before GP's reporter could...

Health Bill limits consortia control over spending.
March 25, 2011... NHS reform RCGP commissioning champion calls for amendments to Health Bill to support NHS hospitals. The Health Bill will lead to GP consortia having less control than PCTs have now over where patients are treated, according to one of the...

DoH plans health tourist crackdown.
March 25, 2011... The existing NHS system for treating foreign visitors is far too generous, according to the DoH. A new consultation on treating foreign patients proposes non-EU residents are charged for visiting GP practices and other non-hospital services....

Arthritis drug could stop malignant melanoma.
March 25, 2011... Results of mouse trial could lead to skin cancer treatment for humans within just five years. A drug for arthritis could be used to treat skin cancer, according to research co-authored in the UK. The drug leflunomide, currently licensed to...

Questions over gastric banding.
March 25, 2011... Half of patients with gastric bands are forced to have them removed within nine years due to complications, research suggests. Research led by Dr Jacques Himpens of Saint Pierre University Hospital in Brussels, Belgium found laparoscopic...

NICE GP advice dismissed as 'not primary care-based'.
March 25, 2011... Research suggests NICE guidance should use more evidence drawn directly from primary care. Researchers have questioned the relevance of NICE guidance to general practice after a study found wide variations in the amount of evidence based on...

Research Briefs - Estimates of MI risk.
March 25, 2011... A more sensitive test for a cardiac biomarker could lead to better estimates of MI risk, UK research suggests. A team from the University of Edinburgh found a new, sensitive troponin test for patients with acute coronary syndrome also increased...

Research Briefs - Taking the weight off.
March 25, 2011... One in five people are too scared to weigh themselves and instead use bathroom scales to weigh luggage and parcels, research suggests. A survey by the Co-operative Pharmacy also found 40 per cent of people admitted to being overweight or obese -...

Price lists slow the rise in cost of 'special' medicines.
March 25, 2011... Legislation is slowing the soaring costs of 'specials'. Rising costs of made-to-order medicines to the NHS slowed following legislation to increase price competition between manufacturers, figures reveal. The cost of GP prescribing of...

JCVI calls for pneumococcal jab scheme to be dropped.(joint committee on vaccination and immunisation )(Brief article)
March 25, 2011... DoH advisors have called for an end to the pneumococcal vaccination programme for the over 65s, after a review found the vaccine gives 'poor' protection. The joint committee on vaccination and immunisation (JCVI) concluded that the protection...

King's Fund inquiry lead speaks exclusively to GP.
March 25, 2011... Back in April 2009, when the King's Fund launched its inquiry into general practice, GPs had their reservations as to what it was trying to achieve. Some saw it as an attack on the profession by a 'bunch of academics looking for errors and...

Partners' pay could be made public.(Brief article)
March 25, 2011... SRM Transparency and price competition - Education - Confidentiality The BMA's special representative meeting has backed a motion that could lead to individual partners' pay being published. The motion called for an end to commercial...

DoH must protect medical training after SHA abolition.(Brief article)
March 25, 2011... The BMA has called on the government to clarify how it will safeguard medical education and training when SHAs are abolished. Delegates at last week's special representative meeting condemned the Health Bill's proposals to abolish SHAs and...

Patient records at risk under reforms.
March 25, 2011... GPs' right to keep their patient records confidential will be removed by the Health Bill, according to BMA experts. Dr Tony Calland, chairman of the BMA's medical ethics committee, said the Health Bill gives the secretary of state 'the power...

Opinion: My innovative approach to screening patients.(Viewpoint essay)
March 18, 2011... 'I have simple tastes,' said Oscar Wilde, 'I am always satisfied with the very best.' When I was a young doc, I didn't quite appreciate this; I didn't mind things being rough and ready, but now that I've matured, I like a bit of comfort and...

Opinion: Why is medicine more complex than life itself?(Viewpoint essay)
March 18, 2011... The approach of the QOF calculation date brings, for me, a series of introspective Read code-focussed evenings which, in a lesser mortal, would lead to a diagnosis of OCD. Relaxing after an evening's exploration of ethnicity data, as Noah and...

Education: Consultation Skills - Communicating risk to patients.
March 18, 2011... Patients have varied concepts of health risk so GPs must communicate effectively, says Dr Peter Tate. As GPs we communicate risk many times every day, so why is it hard to do it well? Risk is like beauty; it is in the eye of the beholder....

Education: CSA troubleshooting: 7 - Home visits.(Clinical Skills Assessment)
March 18, 2011... Home visit cases in the CSA are a problem area for some candidates By Dr MeiLing Denney. On each CSA exam circuit there is a home visit room, but this does not mean every candidate will get this as a case. How it is covered in the CSA exam...

Education: A registrar survival guide ... managing chronic conditions.
March 18, 2011... GPs have an important role in the early detection and prevention of chronic disease as well as diagnosing, managing and treating existing chronic conditions. Therefore, it is important that we do this properly. - Keep your guidelines handy ...

MedEconomics: Revalidation - Top tips on effective reflection.
March 18, 2011... Thinking deeply about your skills and needs is key to successful revalidation. Seize the opportunity to record and reflect on learning events Learning often takes place at the workplace. For example, problem solving is something GPs do all...

MedEconomics: Tracking down the right suppliers.(Brief article)
March 18, 2011... Step 3 Look at alternative sources even if your current suppliers seem satisfactory. Finding suppliers is simple. All you need is the name of the product and access to Google. However, this is such a risky strategy. Not only will you...

MedEconomics: Ask the Experts - Pensions, annuities and drawdowns.
March 18, 2011... Q. Annuity or Drawdown I am retiring at the end of this tax year and took my NHS pension a couple of years ago. I have been paying into a personal pension and do not know if I should buy an annuity or set up a drawdown scheme directly from...

MedEconomics: Race is on to beat tax deadline.
March 18, 2011... Danny Cox has tax-saving tips for GPs to act on before 5 April, when the 2010/11 tax year ends. The 2010/11 tax year ends on 5 April and there are only 19 days to go until then. So waiting to see what the chancellor, George Osborne,...

Commissioning: Prescribing - Consortia and the NHS's drug spend.(National Health Service)
March 18, 2011... Lead GPs must be pragmatic when advising practices on cutting prescribing costs. With the advent of GP consortia, practices are keen to present themselves as cost-effective. This modern-day beauty pageant sees them trying to reduce their...

Commissioning: Viewpoint - Access to psychotherapy services.
March 18, 2011... GP consortia will be empowered to remove local waiting lists, say Carmen Joanne Ablack and Janet Weisz. Many UK Council for Psychotherapy (UKCP) members work in GP surgeries or other primary care settings. In schemes and contracts agreed...

Plain Tales from the Surgery.(Quotation)
March 18, 2011... - The golden rule Whilst helping a female trainee revise recently, I asked: 'What information would you give this lady about her UTI?' She replied comprehensively: 'I would tell her to increase fluids, use analgesia, try cranberry juice...

Clinical: Journals Watch - Diabetes, eczema and cannabis use.(Report)
March 18, 2011... Too busy to plough through a pile of journals? Dr Alison Glenesk rounds up the latest highlights. - Diabetes mellitus and risk of cause-specific death N Engl J Med 2011; 364:829-41 Most of us associate diabetes with cardiovascular...

Clinical: Emergency medicine - Managing seizures in epilepsy.(Report)
March 18, 2011... Deciding whether to refer a patient to A&E or for an outpatient neurology appointment requires considerable clinical judgment. Epilepsy is a neurological disorder characterised by recurrent seizures. It affects one in 200 people and is...

Clinical: Expert opinion - Deep brain stimulation.(Report)
March 18, 2011... The use of DBS in patients with movement disorders is growing, explains Mr Keyoumars Ashkan. The use of electricity to treat brain disorders is not new. For example, there are records of torpedo fish being used to treat headaches in Roman...

Clinical: The basics - Management of alopecia.(Report)
March 18, 2011... Treatment and prognosis depends on the type of hair loss, says Dr Louise Newson. Alopecia describes any type of hair loss. There are various patterns of alopecia with a variety of causes but it is often idiopathic. 1. The hair cycle The...

Clinical: Bacterial infections.
March 18, 2011... Ascending lymphangitis This patient sustained a minor injury on the base of the thumb. He ignored it and he then developed pain going up his arm. The red line can be seen clearly and shows the ascending infection in the lymphatic channels. If...

Lansley says opponents misunderstand reforms.
March 18, 2011... Health secretary insists that consortia will not have to make cuts and few GPs will be involved. Opposition to the NHS reforms is being fuelled by 'wilful misrepresentation' or misunderstandings, health secretary Andrew Lansley said last...

Scotland backs diabetes drug.
March 18, 2011... Patients with type-2 diabetes in Scotland can now be offered an alternative third-line treatment after exenatide (Byetta) was accepted by the Scottish Medicines Consortium (SMC). Exenatide is one of a class of diabetes drugs called GLP-1...

Behind the headlines: Can food packaging give you cancer?
March 18, 2011... Cereal packets made from recycled card contain hazardous levels of toxic hydrocarbons, according to reports. Swiss researchers, who analysed German food product packaging, found levels of mineral oils 10-100 times higher than WHO-recommended...

Opinion: Ballot Box.
March 18, 2011... 76% of GPs think that funding for GP out-of-hours services should be ringfenced to protect them from cuts. Source: GP. -------------------- Did you find this article useful? Why not subscribe to the magazine? Please call 08451 55 73 55 for...

Opinion: Your say online.
March 18, 2011... One in five doctors has worked with an incompetent colleague. - Has anyone read last year's government report Invisible Patients? In some cases, these doctors have mental health and/or substance misuse issues which are often ignored or not...

Clinical Review: Type-1 diabetes mellitus.(Report)
March 18, 2011... Contributed by Dr Anita Pillai, specialist registrar, and Dr Iskandar Idris, consultant, Sherwood Forest Hospitals Foundation Trust, and honorary senior lecturer, University of Sheffield. Section 1: Epidemiology and aetiology Type-1...

Clinical: Book Review - A one-stop authority on cardiovascular medicine for the GP.
March 18, 2011... This book provides just the right level of detail in an easy-to-read, no-frills style, says Dr Raj Thakkar. With increased pressure to provide high-quality medicine in the community, reduce secondary care referrals and meet patient...